Gastric band

Having a gastric band fitted has become a very popular form of bariatric surgery and is usually done privately in the UK. Lap band surgery, as its often called, is reversible and minimally invasive, and so a less drastic route to weight loss compared to other forms of bariatric surgery.

People who have a gastric band can expect to lose half of their excess body weight in the first year after it has been fitted. It is, however, not an easy option. Part of the preparation for a gastric band operation is adopting a new approach to food and eating; you must be prepared to change your lifestyle if you are to achieve the weight loss you want.

What is a gastric band?

A gastric band is an inflatable, thin silicone band placed around the top of the stomach during laparoscopic surgery (hence the name lap band). Also called keyhole surgery, this technique involves using instruments placed inside the body cavity through five very small incisions. Mr Alhamdani works using images from a camera placed through one of the ports, manoeuvring the gastric band into place.

Lap band surgery is performed under general anaesthetic – you will be completely asleep throughout and unaware of what is happening.

The band itself is inflatable; a tube attached to the band is attached to a small port in the skin of the abdomen during the surgery. Saline can be injected through this port to increase the pressure that the band places on the stomach. This can be done immediately after surgery but it is also possible to have ‘top ups’ during the next few months if weight loss slows down.

The operation takes about an hour most people stay in hospital overnight. After that, recovery from the surgery is fast; the small incisions heal quickly and leave little scarring.

How does a gastric band aid weight loss?

Once the gastric band is in place, this squeezes the stomach, creating a small pouch that can take food that is swallowed. This food must be partially digested before it can pass into the lower part of the stomach and into the rest of the digestive system. This means that you can only eat small amounts of food without feeling uncomfortably full and once you have a band in place, you must chew your food very carefully, eating small portions slowly.

This reduces the overall amount of food that you can take in during each day. The rate of weight loss you will see depends on how much weight you have to lose, the types of food you choose to eat and whether you exercise or have an inactive lifestyle.

How can I prepare for gastric band surgery?

Mr Alhamdani recommends a liquid diet for around two weeks before the day of your operation. This is low in fat and helps to shrink your liver to make the lap band surgery more straightforward. It also initiates some weight loss and helps you to prepare mentally for the change in eating habits that you will need to make after surgery. You will also have the routine pre-operative checks on blood pressure and your general health to make sure that all is well.

What happens after surgery?

You will recover from the surgery quickly and most patients experience very little pain. You will continue to eat a liquid diet – this is important because it allows the stomach tissue to recover. After a few weeks you can start eating soft foods and then can move on to a wider range of foods.

You must eat very small portions and chew your food, eating slowly, making each meal last about 20 minutes. If you overfill the top of your stomach, this can cause severe stomach ache, nausea and vomiting.

As part of our multi-disciplinary team approach you will see Specialist Bariatric Dietician Mrs Lucy Jones or Specialist Nurse Practitioner Mrs Toni Jenkins during your stay in hospital who will talk to you about your diet and how to lose weight with your gastric band.

Weight loss in the early weeks is gradual, but it can level off. At this point, Mr Alhamdani may recommend that more saline is introduced into the band to adjust it, ensuring your food intake continues to be restricted.

Problems and complications

Complications of surgery. Any type of surgery carries the risk of developing an infection, bleeding, reaction to the anaesthetic or a blood clot (deep vein thrombosis) and those risks are heightened if you are obese. That said, the complication rate for gastric band surgery with Mr Alhamdani is low.

Gastric band slippage. The band can slip or even start to bite into the stomach wall. We can offer gastric band repositioning, replacement or removal to patients who have problems; most of these procedures are done in patients who had their original surgery elsewhere.

Difficulty adjusting to the change in lifestyle. As Mr Alhamdani will explain if you come for a consultation, the gastric band itself cannot change how you eat. You must adjust your lifestyle. Some patients find it difficult to eat very small meals and have the liquid diet initially and find that they become ill if they try to eat normally.

Living with a gastric band

Once you have adjusted, eating small meals and chewing well becomes a way of life. Many patients are delighted with the rate of weight loss they achieve. Having a gastric band helps them gain control of their eating habits and build a new relationship with food, something that proved too difficult to do by diet and exercise alone.

Gastric bands are designed to stay in place for good, but they can be removed if clinically indicated or if a complication has arisen at any stage.

Mr Ali Alhamdani is a Consultant Bariatric Surgeon with many years' clinical experience within NHS teaching hospitals in London. He has also worked in the United Arab Emirates and Iraq, providing general surgery and welcomes international patients to his London-based private practice.